民航飞行人员高血压病危险因素与心率变异性及压力反射敏感度的联系

Association between risk factors of hypertension and heart rate variability and baroreflex sensitivity in civil flying personnel

目的 探讨民航飞行人员高血压病危险因素暴露与心率变异性 (HRV)及压力反射敏感度 (BRS)之间的联系。 方法 在参加年度大体检的 45 0名血压正常的民航飞行人员中 ,根据有无危险因素暴露将其分为年龄≥ 40岁组、体重超重组、血脂异常组、吸烟组、饮酒组及相应对照组。采用常规自回归谱分析方法对各组飞行人员的短时程 HRV信号进行分析 ,同时采用序贯法计算其 BRS。 结果 与对照组相比 ,年龄≥ 40岁的飞行人员 HRV明显降低 ,表现为总功率 (TP)、低频功率(L F)、高频功率 (HF)及归一化高频成分 (HFn)显著降低 (P<0 .0 1) ,而归一化低频成分 (L Fn)与L F/ HF则显著增加 (P<0 .0 5 ) ;其 BRS亦显著降低 (P<0 .0 1)。其他危险因素暴露时 ,HRV的 TP、L F及 HF均显著降低 (P<0 .0 5 ) ,而 L Fn、HFn及 L F/ HF则无明显变化 ,BRS亦显著降低 (P<0 .0 5 )。 结论 民航飞行人员高血压病危险因素的暴露与 HRV及 BRS的降低密切联系 ;提示在高血压病发病之前 ,心血管自主神经调节功能即已发生异常。

Objective To explore the association between the presence of risk factors of hypertension and heart rate variability(HRV) and baroreflex sensitivity(BRS) in civil flying personnel. Methods A total number of 450 civil flying personnel with normal blood pressure level were divided into 5 paired groups according to the presence of risk factors of hypertension, that is age≥40 and age<40 groups; overweight and normal weight groups; abnormal lipidemia and normal lipidemia groups; smoking and non smoking groups and drinking and non drinking groups. Each pair groups were mutual matched according to the presence of other risk factors. The HRV was analyzed and BRS was evaluated in the flying personnel of each group by conventional autoregressive(AR) spectral analysis and sequence method respectively. Results As compared with age<40 group, total power(TP), low frequency(LF), high frequency(HF) and normalized high frequency(HFn) of HRV were significantly reduced in the flying personnel of age≥40 group ( P <0.01 for both) whereas normalized low frequency(LFn) and the LF/HF ratio increased markedly( P <0.05 for both). The BRS in the flying personnel of age≥40 group was also significantly lower than that of age<40 group( P < 0.01 ). The TP, LF, HF and BRS were significantly reduced in the flying personnel of overweight group, abnormal lipidemia group, smoking group and drinking group, as compared with respective control groups ( P <0.01 or P <0.05). The differences of LFn, HFn and LF/HF between these pair groups were non significant. Conclusions The results suggest that the occurrence of significant abnormality in regulatory function of autonomic nervous system is prior to hypertension, and attention should be paid to the evaluation of regulatory function of autonomic nervous system in the early risk prediction for hypertension in civil flying personnel.